Claim total
$106.95
base $93.39 · payer covered $56.95
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2022-03-22
- Stop
- 2022-03-22
The parties
- Patient
- patient Louella Roberts
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
05092f50-4c35-2d72-f60d-38c1e86d7f24